Good morning! Two years ago I had a severe bout of vertigo which declined gradually over 2-3 weeks and which the doctors diagnosed as vestibular neuritis. At the time they also gave me a hearing test and diagnosed the early stages of presbyacusis . I had already been prone to bouts of vertigo which would start without warning; they would go away after hours or days but I'd often be left with a kind of "brain fog" which could go on for weeks. The vertigo always seemed to come from the right side; often I would feel that I was going to fall over to the right but I never had nausea or vomiting with it. Neither did I seem to lose my hearing. For a long time the doctors said it was just stress and depression because (until the bout of vestibular neuritis when I had "decompensated vertigo in the horizontal semicircular canal") there were no pathological findings. Thankfully the vertigo has become less extreme over the years; however over the last few months I feel as if my hearing has been getting worse. I often have to ask people to repeat themselves at least once or guess at what they are saying and it is becoming a major nuisance. Anyway yesterday I saw an ENT specialist about the hearing loss. He did an audiogram of both ears which showed the pattern typical for presbyacusis but also a low-frequency "notch" in the right ear: Right ear: 250 Hz=15 db 500Hz= 30 db 1000 Hz= 20 dB 2000 Hz=15 dB 4000 Hz= 30 db 8000 Hz = 50 db Left ear: 250 Hz=10 db 500Hz= 10db 1000 Hz= 15 dB 2000 Hz=15 dB 4000 Hz= 30 db 8000 Hz = 40 db He also did a tympanogram which - if I understood him correctly - revealed low pressure in the right ear. Now he has given me betahistine (24 mg three times a day) and muttered something about cortisone infusions but I have no clue what is going on? (to be honest I was so baffled I couldn't collect my thoughts to ask more questions). Does this sound like Meniere's or something else? Many thanks in advance!
2014-11-19 11:33:47
Hello. The low frequency notch is the right ear is evidenced by the higher number at 500 Hz (30). Your hearing is normal at 250 drops at 500 and improves at 1000 so that it appears as a notch when you visualize it on a graph. Other than that your hearing loss appears to be typical of presbycusis with hearing gradually worsening in the high frequencies. It is still relatively near normal in terms of everyday listening situations but it's a good idea to have an annual test and take precautionary measures such as ear protection proper diet and exercise. Sometimes it is difficult to unravel the contributory factors in the diagnosis of hearing loss and the vertigo history is suggestive of Meniere's. You should continue following up with your ENT for treatment and of course if you have additional questions get a second opinion.
2014-11-19 11:34:23
